Saturday, April 30, 2005

They Need A Better Comparison Group

This web site, TeachTheFacts.org, is here to provide support for the new sex-education curriculum in the Montgomery County public schools. Some people have attacked it, but we think it's really pretty good, certainly nothing to get in a tizzy about. The Family Life and Human Sexuality curriculum is one part of a comprehensive health curriculum that includes all sorts of other things, from personal hygiene to mental health. Kids come to school, and this is one of their classes. For less than an hour a day for several weeks they sit through a class, learning about sex in its many aspects, bam-bam-bam, one thing after another, and then on to the next class.

A couple of posts down I mentioned a Washington Times article about a program that resulted in fantastically high abstinence rates among the girls who participated in it: Abstinence program shows results. I didn't really talk about the program, but about some things that were said about us. It's time to talk about the program.

The program referred to in the Times, called Best Friends (the girls' component is called Diamond Girls), is not like our sex-ed curriculum. It's not what we'd call an "abstinence program" in the usual sense of the word -- it's not part of a health class, but an all-absorbing lifestyle-monopolizing course that we would call, if we lived in the South, "finishing school." Here's what the girls do (from their web site):

What Is Best Friends?Best Friends is a school based character-building program for girls that begins in the sixth grade and continues until high school graduation. Best Friends provides a developmentally sound curriculum in an educational setting which promotes fun, companionship, and caring. When Best Friends girls reach ninth grade, they enter the Diamond Girls Leadership program designed to keep girls interested, involved, and committed to abstinence through high school and until marriage. All Diamond Girls participate in the Diamond Girls Jazz Choir or Performance Dance Troupe which fosters discipline as well as the social and presentation skills important for future success. Our goal is for all Diamond Girls to graduate from high school with specific college, vocational, or career plans.

CurriculumBest Friends provides a character-building curriculum with an abstinence-only philosophy, an intensive peer support structure, and long-term adult involvement. Each year, Best Friends girls receive at least 110 hours of instruction, mentoring, and group activities.

The Best Friends Curriculum includes:

Group DiscussionGirls discuss and receive guidance on the topics of friendship, love and dating, self-respect, decision-making, alcohol abuse, drug abuse, physical fitness and nutrition, AIDS and STDs. Group discussion sessions are conducted during the school day at least once a month.

Role Model PresentationAt least twice a year distinguished women from the community meet with the girls to discuss their own lives and families and the important decisions they made when they were young.

Mentor MeetingsEach Best Friends girl has a mentor, a member of her school faculty, who meets with her for 30 to 45 minutes each week. Girls select their own mentors from a list of teachers who have agreed to participate.

Community ServiceGirls are required to participate in at least one community service project each year such as Race for the Cure, clothing drives to benefit the homeless, adopting a community day care center, and reading to children.

"Make Music Not Madness"This is our new all-school outreach effort designed to deliver the messages of abstinence from drugs, alcohol, and premarital sex to the entire student body. Our goal is to utilize Best Friends and Best Men as role models for their fellow students, helping them say "no" to risk behavior and "yes" to positive music and positive choices.

Annual Family and School Recognition CeremonyAt the end of the school year, the Best Friends girls, Diamond Girls, mentors, and parents are honored. The ceremony is held to showcase the Best Friends girls and Diamond Girls and their commitment to the Best Friends messages through music, dance, and public speaking. Girls are recognized by their family, school, community, and national leaders. College scholarships, awards, and prizes for outstanding essays are presented. What Is Best Friends?

The Times reported on a study that compared the Diamond Girls to ordinary high-school students:

The Diamond Girls were more than 100 times less likely to engage in premarital sex than high school girls who were not in the program, study author Robert Lerner said yesterday....The Lerner study compared several years of data on Best Friends girls in the District with data from girls of the same age and in school districts that were part of the federal Youth Risk Behavior Surveillance Survey (YRBS).

Mr. Lerner found that Best Friends girls were eight times less likely than YRBS girls to use drugs and more than six times less likely to have premarital sex -- both strong outcomes.

Best Friends girls were more than twice as likely to not smoke and almost twice as likely to not drink alcohol as YRBS girls. More than 2,700 girls were involved in this comparison.

The paper is not available online, but I'm sure that Dr. Lerner partitioned his variance in such as way as to account for the differences between girls who choose to join the program and those who did not, sampling bias, that is. (Especially since he is probably best known for a paper criticizing other studies for their methodology, including sampling error.)

But is the general population a proper comparison group? Ordinary kids have time during the day to do things, like date and socialize and hang out, things that sometimes lead them into situations where they have to make hard decisions. These girls, it sounds like, were kept busy, singing jazz songs, attending enriching events, serving their communities ... not a fair comparison.

I think it would have been more appropriate to compare abstinence and drug use between the Diamond Girls and a group of Catholic girls who have chosen to become nuns and are living in a convent. Because if abstinence rates are a hundred times higher for the Diamond Girls, I'd bet they're thousands of times higher for teenage nuns. I'll bet you could go a long time before you even found a teenage nun who used drugs at all, and I think -- I hope -- that very nearly all of them are virgins.

Look, if you want your daughter spending all her time doing community service, attending enrishing events, meeting with mentors, and being a role model for ... the kids who have lives ... then you can be pretty sure to keep that hymen intact until she leaves high school, at least.

The public schools are not going to provide that through the health curriculum. All the health curriculum does is teach health. And as it is proposed, it is doing a really good job of that.

6 Comments:

well, we don't really want to compare apples and oranges or apples and apples, even- or do we?. This is like comparing apples to a cruise ship buffet. As you said Best Friends isn't a health ed class in abstinence only- it is a whole program which probably helps these kids in many ways-personal mentoring, music,math(I believe in the math- music connection), community service, significant group activities in and outside of school. These kids are probably also doing better at a number of school subjects than lots of other kids as well. I'm sure they have a much higher graduation rate than the general population as well. But again- it isn't the difference between one health class and another-not at all. Let's see the comparisons again from the actual abstinence-only health classes- those were pretty poor according to Congress- just like the very sad results from the kids who pledged abstinence and had higher STD rates from not "having sex"-or what they thought was not having sex(anal and oral)- not enough education being a very dangerous thing for them.

Let me first say that I am a strong supporter of the MCPS's comprehensive sex ed curriculum, including the recent revisions to the 8th and 10th grade lessons. And I appreciate TTF's efforts to make sure that it is depicted accurately in the media, on the web, etc. I also have been appalled by CRC's misrepresntations of the curriculum and, even more so, how CRC has aligned itself with judgemental, intolerant, prejudiced extremists to tout an agenda that really has little to do with the MCPS curriculum at all. All that said, however, I must take issue with this BLOG posting about Best Friends and Abstinence only programs generally -- to characterize such programs with flip remarks such as comparisons to "teen nuns" and trite statements like all they want to do is keep girls' "hymens in tact" is neither constructive nor instructive.

The best scientific research on teen pregnancy prevention programs -- that is, the studies with the most rigourous methology and study designs -- have consistently shown that comprehensive sex education programs work to delay first sex, improve contraceptive use, and reduce the incidence of teen pregnancy. The same has not been shown for abstinence-only programs, primarily because no good evaluations have been done that use random assignment and other reliable methodolgies. So the conclusion about their effectiveness is, well, that there is no conclusion... the jury is still out regarding their effectiveness in delaying sex and their impact (if any) on other sexual behaviors. This includes Best Friends, which has touted positive outcomes for its participants before, but which has not done a high-end, randomized, evalution to prove it.

So what does all that mean? That those of us who really want our kids to avoid too-early childbearing and STDs should support comprehensive sex education because it has been shown to work. But if at some point good research emerges that shows some benefit of an abstinence program, we should also be open to learning about the elements that make it effective and consider them rather than simply slamming the door because of the "category" of program that it is. Teen pregnancy prevention is not a single-solution issue .... whether teens have sex or not has to do with much more than condom videos or virginity pledges. It has to do with hope, self-confidence, motivation, and understanding about what's at stake.

As the saying goes, the most important sex organ is the one between the ears.

Of course I agree with you entirely about comprehensive sex-ed. I suppose the reason I even brought up this subject is that the Best Friends report was being used to promote "abstinence education" (an oxymoron) in place of comprehensive sex-ed. The methods are different, the goals are different, and the results are different. This study says nothing about whether these young ladies can practice safe and responsible sexual behavior once they leave high school, but one assumes they will be ignorant about it all.

You're not a kid forever, and school should be a place where you learn to be an adult.

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